Point-of-care magnesium monitoring in athletes: a physiological framework for exercise-related arrhythmic...

To summarize physiological mechanisms linking exercise-induced magnesium (Mg²⁺) imbalance to electrophysiological instability in athletes, discuss limitations of serum-based assessment, and propose a conceptual framework for rapid point-of-care magnesium monitoring.

Peer-reviewed evidence from exercise physiology, sports medicine, cardiovascular electrophysiology, and biosensing/wearable-technology literature indexed in PubMed, Scopus, and Web of Science.

Studies addressing magnesium loss during exercise (sweat and renal excretion), intracellular Mg²⁺ physiology, repolarization dynamics (including QT modulation), arrhythmogenic mechanisms, and analytic approaches for rapid or wearable electrolyte assessment.

Key findings were synthesized regarding Mg²⁺ homeostasis, limitations of conventional biomarkers, feasibility of point-of-care monitoring, and implications for athlete physiological monitoring.

Intense exercise may promote transient Mg²⁺ fluctuations, potentially affecting intracellular availability while serum Mg²⁺ remains within normal limits. Transient Mg²⁺ depletion may influence cardiac repolarization dynamics and contribute to electrophysiological vulnerability during intense exertion. Current screening strategies primarily identify structural or baseline electrical abnormalities and do not capture acute metabolic-electrolyte vulnerability during exertion. Emerging minimally invasive and wearable biosensors may enable rapid Mg²⁺ assessment and support broader physiological monitoring strategies in athletic settings.

Integrating rapid Mg²⁺ monitoring into athlete physiological assessment frameworks may complement existing screening approaches by providing additional insight into acute metabolic and electrolyte-related stress during training and competition. Validation studies assessing analytic accuracy, correlation with intracellular markers, and prospective field implementation are required for clinical translation.